Breakthrough on Antipsychotic Maintenance Medication: An Individual Participant Data Meta-Analysis.

Breakthrough on Antipsychotic Maintenance Medication: An Individual Participant Data Meta-Analysis.

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Dr. Kane receives honoraria from Alkermes, Eli Lilly, EnVivo Pharmaceuticals (Forum), Forest (Allergan), Genentech, H. Lundbeck, Intracellular Therapeutics, Janssen Pharmaceutica, Johnson and Johnson, Neurocrine, Otsuka, Pierre Fabre, Reviva, Roche, Sunovion, Takeda, and Teva as a consultant for expert testimony; receives honoraria from Alkermes, Intracellular Therapies, Lundbeck, Neurocrine, Otsuka, Pierre Fabre, Takeda and Teva as an advisory board member; receives stock from Medavante Inc., Vanguard Research Group, LB Pharmaceuticals, Inc., as a shareholder, receives grant support form Otsuka and Janssen as an investigator

Antipsychotic drugs are effective in reducing the risk of relapse in schizophrenia. However, about 15% of patients relapse despite optimal adherence with maintenance antipsychotic treatment. This phenomenon is known as breakthrough on antipsychotic maintenance medication (BAMM), and represents an important challenge in the long-term treatment of schizophrenia. Understanding the factors involved in relapse despite adherence with antipsychotic maintenance treatment is important to develop early interventions for these individuals, as well as to understand the mechanisms underlying this phenomenon. We aim to capitalize on existing data from randomized controlled trials of maintenance treatment clinical trials of long acting injectable antipsychotics in schizophrenia to study the factors involved in BAMM. We will do so by pooling data from various of these studies in what is known as an individual participant data meta-analysis. This is a powerful statistical technique to study risk factors as they occur across various comparable clinical samples. We believe that this work will be very useful in understanding what are the risk factors of BAMM, and therefore who are the individuals that should receive early intervention, as well as what are the potential mechanisms involved in the failure to respond to maintenance antipsychotic treatment in schizophrenia.

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